Anna Ivanenko, MD PHD

Primary specialty

Sleep Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0012X

License

036108993 Issued in IL

Practice address

800 Biesterfield Rd
Suite 510
Elk Grove Village, IL 60007-3361

Phone

(847) 981-3660

Fax

(847) 956-5108

NPI assigned

Mar 7, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

PsychiatryAlso: Sleep Medicine

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Child Psychiatric Services, LTD.

  • Clinical Neuropsychologist
  • Northfield, IL
  • NPI 1386818011
  Medicare reassignment
• Alexian Brothers Medical Care Group NFP

  • Pulmonary Disease Physician
  • Elk Grove Village, IL
  • NPI 1518420413
  NPD (past)
• Loyola University Physician Foundation

  • General Practice Physician
  • Maywood, IL
  • NPI 1235148891
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1255308334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "SUITE 510",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-981-3660",
            "fax_number": "847-956-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "SUITE 510",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-981-3660",
            "fax_number": "847-956-5108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANENKO",
        "first_name": "ANNA",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "36108993",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "IL",
            "license": "036108993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36108993",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "1617373",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sublung@380.direct.myezyaccess.com",
            "affiliation": "N",
            "address_1": "800 Biesterfield Rd",
            "address_2": "Suite 510",
            "city": "Elk Grove Village",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600073361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Integrated Cardiovascular Imaging LLC
• Iria E Irlanda, MD
• Terrance Irving Sr.
• Rimma Isaac, MA, LPC
• Eduardo M Israel, M.D.
• Daniel Winston Ives, M.D.
• Jessica Elyse Jablonski
• Lynnette Marie Jacobs-Pupino, MD
• Jennifer Jacobs, APRN
• C Meghan Jacobson

• Sleep Medicine (Psychiatry & Neurology) Physician in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Sleep Medicine (Psychiatry & Neurology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.